Dr. R.B. Hines

The applicant sought statutory accident benefits following a motor vehicle accident, claiming entitlement to non-earner benefits and various medical and assessment plans outside the Minor Injury Guideline (MIG).

The adjudicator found that the applicant's injuries were predominantly minor, noting a lack of persuasive evidence for accident-related psychological, neurological, or chronic pain impairments.

The adjudicator preferred the insurer's medical reports and highlighted inconsistencies in the applicant's self-reporting, including a subsequent cycling accident and surveillance showing her working.

The application was dismissed, with no entitlement to the disputed benefits, interest, or an award.

The applicant was involved in a motor vehicle accident and received an Income Replacement Benefit (IRB).

The respondent insurer sought repayment of $101,571.44, alleging the applicant willfully misrepresented his functional abilities and receipt of collateral disability benefits.

The Tribunal found no willful misrepresentation regarding functional abilities or CPP disability benefits, but found the applicant willfully misrepresented his receipt of $43,400 in disability income from RBC Insurance.

The Tribunal ordered the applicant to repay $27,000 of the IRB, representing the overlapping period, plus interest.

The applicant, a plasterer, was injured in a motor vehicle accident and claimed ongoing income replacement benefits (IRBs) and medical benefits for a chronic pain condition.

The insurer terminated IRBs, arguing the applicant's chronic pain lacked objective medical evidence and was driven by pre-existing psychological factors.

The arbitrator found that the applicant developed a bona fide chronic pain condition as a result of the accident, rendering him substantially unable to perform his essential tasks or any suitable employment.

The arbitrator awarded ongoing IRBs, various medical expenses, and assessment costs.

Furthermore, the arbitrator ordered a special award of $7,500 against the insurer for unreasonably withholding payments and failing to properly assess the applicant's chronic pain condition.

The applicant was injured in a motor vehicle accident and received statutory accident benefits, including income replacement benefits (IRBs), which the insurer terminated after approximately 21 months.

The applicant sought ongoing IRBs under both the pre-104 week 'own occupation' test and the post-104 week 'any occupation' test.

The arbitrator found that the applicant sustained significant orthopaedic injuries, particularly to his right hip and left hand, which prevented him from performing the heavy physical demands of his pre-accident employment as a welder.

Furthermore, given the applicant's limited English proficiency and lack of transferable skills, the arbitrator concluded he suffered a complete inability to engage in any employment for which he was reasonably suited by education, training, or experience.

The applicant was awarded ongoing IRBs and interest, but his claim for a special award was dismissed as the insurer's reliance on its medical assessments was not unreasonable.